title: Outcomes of robot-assisted radical prostatectomy in men with previous transurethral resection of prostate.
abstract: OBJECTIVE
  • To critically analyze and compare surgical, oncological and functional outcomes of robot-assisted radical prostatectomy (RARP) in patients with and without previous transurethral resection of prostate (TURP).
  
  
  METHODS
  • The study comprised 158 cases of RARP for clinically localized prostate cancer, including 26 cases that had undergone previous TURP (Group A). • Surgical, oncological and functional (short- and intermediate-term) outcomes of Group A were compared with 132 cases without previous TURP (Group B).
  
  
  RESULTS
  • Post TURP patients were found to have significantly greater blood loss (494 vs 324 mL) and a need for bladder neck reconstruction (26.7% vs 9.7%) compared to the non-TURP group. • Surgical time (189 vs 166 min), conversion rate, margin positivity rate and biochemical recurrence rate were also higher. • Incontinence rates were higher both at 6 (14% vs 11.8%) and 12 (25% vs 8%) months follow-up.
  
  
  CONCLUSIONS
  • RARP is feasible but challenging after TURP. It entails a longer operating time, greater operative difficulty and compromised oncological or continence outcomes. • These cases should be handled by an experienced robotic surgeon with the appropriate expertise.
authors.affiliation: Academic & Research, Urology, Medanta Institute of Kidney and Urology, Medanta - The Medicity, Gurgaon, Delhi, India.
authors.forename: Narmada P
authors.initials: NP
authors.lastname: Gupta
authors.forename: Prabhjot
authors.initials: P
authors.lastname: Singh
authors.forename: Rishi
authors.initials: R
authors.lastname: Nayyar
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000601:surgery*; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery*; D012086:Reoperation; D012307:Risk Factors; D012371:Robotics; D020728:Transurethral Resection of Prostate; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology